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Comparative Study
. 2008 May;138(5):601-5.
doi: 10.1016/j.otohns.2008.01.013.

Carcinoma ex pleomorphic adenoma: diagnostic difficulty and outcome

Peter Zbären  1 , Sibylle Zbären, Marco D Caversaccio, Edouard Stauffer
Affiliations
Comparative Study

Carcinoma ex pleomorphic adenoma: diagnostic difficulty and outcome

Peter Zbären et al. Otolaryngol Head Neck Surg. 2008 May.

Abstract

Objective: To analyze a series of carcinoma ex pleomorphic adenoma (CXPA) and to assess the diagnostic difficulties.

Study design: The clinical presentation of 24 CXPAs was compared with 300 pleomorphic adenomas (PAs). Furthermore, pathohistological findings and follow-up results of CXPAs were evaluated.

Results: Eight of 24 (33%) CXPAs versus 41 of 300 (14%) PAs were localized in the deep lobe (P < 0.05). Forty-two percent of CXPAs versus 6 percent of PAs, respectively, were greater than 4 cm (P < 0.05). The sensitivity in detecting CXPA by fine-needle aspiration cytology (FNAC) was 47 percent. The tumor was known to be malignant preoperatively in 10 (42%) patients. Six of 24 (25%) patients with CXPA developed a tumor recurrence. The overall 5-year survival rate of CXPA was 76 percent.

Conclusion: CXPAs are difficult to identify preoperatively. FNAC has a low accuracy and sensitivity. CXPAs versus PAs are significantly more frequently localized in the deep lobe and are significantly greater in size.

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